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#1
New User Check in
Greetings! Thank you for allowing me to join the community.  I am a new CPAP user on my second week of treatment. I was diagnosed with a mild sleep apnea using a home study kit. The doctors visit is a few weeks out and looking for some advice. I am having a lot of OA and CA events.  Also wondering why i don't have a MAX statistic but only 99.5% I couldn't figure out if that can be changed.

I am using a ResMed AirSense 11 with a ResMed AirTouch F20 mask. I have a beard and an upper overbite so it's been a bit of a struggle getting a mask with a good seal but I think I am finally getting it. The pressure is set to 6-12 with EPR 2 and Ramp off.  Temp at 78F with a humidity 4 setting.

Is there anything I could be doing better here or is it premature and I need to spend more time with the machine and adapt to it? This is the longest I've been able to keep the unit on and sleep with. Feedback is much appreciated.


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#2
RE: New User Check in
The 2 things I see you need to address is - mask leaks. As you said there is a problem there and it is something many people work on. If you only need akustmemt or a different mask I don’t know but keep trying to stop the lm arks. In wiki (top of the site) there are tips about masks you should look at.

The other is you have some positional apnea. Positional apnea is from getting into a position that cuts off your own airway. Think of it as a linked hose. No pressure changes can help only staying out of that position can stop them. Any time your chin drops down to your Sternum you are cutting off your air flow. Try not sleeping on your back or Chang pillow to a thinner one might help if not the link in my signature on collars will many people here use them to stop positional apnea.

You can see positional apnea where there are clusters of OA and/or H events.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#3
RE: New User Check in
(11-03-2021, 10:40 AM)staceyburke Wrote: The 2 things I see you need to address is - mask leaks. As you said there is a problem there and it is something many people work on. If you only need akustmemt or a different mask I don’t know but keep trying to stop the lm arks. In wiki (top of the site) there are tips about masks you should look at.

The other is you have some positional apnea. Positional apnea is from getting into a position that cuts off your own airway. Think of it as a linked hose. No pressure changes can help only staying out of that position can stop them.  Any time your chin drops down to your Sternum you are cutting off your air flow. Try not sleeping on your back or Chang pillow to a thinner one might help if not the link in my signature on collars will many people here use them to stop positional apnea.

You can see positional apnea where there are clusters of OA and/or H events.

The doctor did mention my AHI was much higher on my back versus sleeping on the right side in the sleep study. With this mask style its a bit more difficult sleeping on the side. I will keep trying. I am using an The Eliminator Series Sleep Aid Cushion to prevent dropping the chin. But I am finding that a larger one might be needed. I will look into the 4" Cervical Collars.

The other thing is my nasal passages seem to get stuffy on my back as well forcing more mouth breathing, which is not an issue while I am upright and not sleeping. I imagine this is contributing to the positional apnea. I was going to have it checked for a deviated septum is that something that can be helped with a surgery as well?
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#4
RE: New User Check in
The other thing is that your flow limits are significantly driving your pressure though they are not "high"..Bump your EPR up to 3 to help this.
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#5
RE: New User Check in
(11-03-2021, 11:17 AM)Gideon Wrote: The other thing is that your flow limits are significantly driving your pressure though they are not "high"..Bump your EPR up to 3 to help this.

Can you elaborate a bit? I understand that EPR reduces the exhale pressure to make it easier to breathe but how does that relate to the flow limits? Thanks!
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#6
RE: New User Check in
The EPR controls flow limits while a higher pressure controls OA events and centrals can get worse with EPR at least if you are having them as your body adjusts to the pap therapy. It is all a balancing act to get the best AHI AND comfortable therapy.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#7
RE: New User Check in
Also flow limits, H and O events are ALL apnea. You can see how they are categorized in my signature.

Flow limits are the smallest type of apnea and your pap machine reacts to the flow limits by raising pressure to stop them from becoming H or OA events.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#8
RE: New User Check in
EPR is a limited form of PS or Pressure Support on a BiLevel. PS is simply the difference between Exhale and inhale pressure and is one of the best tools to treat Flow Limits, RERAS, UARS, and Hypopneas. EPR is limited to the values 1,2, or 3 where PS goes much higher and can be set in fractions. EPR is only marketed as a comfort feature but its therapeutic valuemakes ResMed one of the Best xPAPs out there.
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#9
RE: New User Check in
Here is an updated data log from last night after EPR has been set to 3 and I attempted to sleep on my side. Looks like the leaks are greatly reduced.  But I also woke up kind of bloated and burping all over the lace, took off the mask and finished the night without it.


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#10
RE: New User Check in
It is possible that you swallowed air, along with breathing it in.   Usually, that  occurs at higher pressures than 11 or 12. It may be an off night.  Keep up the good work.

I read somewhere that laying on your left side is better for you than on your right side.  Some quack, probably. I do mostly lay on my left side and seem to pass any swallowed air to the bedroom environment.  I never know one way or another because I am asleep and my co-inhabitants do not mention it.

QAL
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